OMM: Research in Obstetrics

00:01 So there's been some research performed looking at how osteopathic manipulation could influence different aspects of pregnancy.

00:09 So there were some older reports looking at Labor time on average.

00:15 So we had patients that had their first child and then with OMT the average labor time was nine hours 20 minutes and without it was 15 hours if they had a previous child having OMT had an average delivery time of five hours without OMT nine hours.

00:38 So you can see how OMT was able to decrease overall labeled labor time.

00:45 There was another published study looking at pregnant women who received OMT versus those who did not and the OMT group had decreased complications compared to the non OMT group with less meconium staining less preterm delivery less need for forceps and a slightly lower C-section rate.

01:07 There was a study looking at the application of putting inhibitory pressure in the lumbar region versus placebo, which they put pressure on the upper thoracic region.

01:17 And so with the patients out of 500 patients 352 had complained a lower back pain during labor Group 1 received lumbar pressure and of the group that received lumbar pressure 23% of requested major pain meds and 4 % received minor pain meds, whereas group to which had to Placebo or the upper thoracic pressure 33 % of those required and requested major pain medications and 8.3% requested minor pain medication.

01:53 So you can see what this study that the application of Lumbar inhibitory pressure help to decrease the need for major pain medications or just pain medications in general.

02:07 More recently, there was a large study published which was funded by the NIH looking at how osteopathic manipulation could help with women from their third trimester on with lower back pain and they were able to show that they were able to decrease the amount of a lower back pain during pregnancy.

02:28 And so what I wanted to do was to share with you the protocol to give you ideas and consideration in terms of what you can do and treat for pregnant patients and the safety of this protocol was proven as there was very few side effects and complications from it.

02:45 And so the study protocol started with the patient seated and they performed in articulatory technique on the thoracic spine to try to improve thoracic compliance.

02:56 The patient was then placed and supine and cervical soft tissue and myofascial was performed followed by a thoracic Inlet model fashion release.

03:07 And a lateral recumbent position patients had their scapulothoracic junction release with myofascial release and then lumbosacral soft tissue technique.

03:20 In the Supine position, they did doming of the abdominal diaphragm and then at the pelvis it was concentrated techniques to try to improve any sort of ligamentous train and improve pelvis mobility.

03:35 There was a anterior posterior pelvic diaphragm on winding SI articulatory technique of frogleg sacral balance ligaments is tension technique ileal muscle energy rotations and pubic decompression.

03:50 So all Of these different techniques were geared to trying to improve sacral pelvic mechanics and to try to decrease any sort of restrictions in the area.

03:59 Finally, the patient was treated with a CV4 to help treat any cranial dysfunctions.

04:07 So you can see here a graph of the summary of the results.

04:10 The red line was the group treated with OMT with usual obstetric care.

04:16 The blue line was ultrasound sham with usual obstetric care and then the green line was usual care only and you can see how even though the OMT group had more pain to start it stayed relatively even and did not increase like the other two groups.

04:38 So overall the OMT group presented with worst disability scores at the end had the best scores.

04:45 So overall research has found that there are significant benefits with OMT and pregnancy decreases the probability of having meconium staining, decreases the use of forceps decreases the likelihood of having preterm delivery and decreases the duration of Labor.

05:02 Overall, it could also potentially help decrease blood pressure, decrease fluid overload decrease sacroiliac dysfunction thus decreasing low back pain and decrease carpal tunnel symptoms.

05:15 Prior to performing OMT we have to be very clear on the indications and contraindications during pregnancy.

05:21 So indications include treating somatic dysfunctions during pregnancy, if patients have scoliosis or other structural conditions associated with pregnancy at reading edema congestion or other pregnancy associated condition that could benefit from OMT is indication contraindications include undiagnosed vaginal bleeding, any threatened or incomplete abortion, ectopic pregnancy, placenta praevia, placenta abruption premature rupture of membranes preterm labor, prolapsed umbilical cord eclampsia and severe preeclampsia and other surgical medical emergencies.